THE very sad case of the child known in the media as Baby P has stimulated a call for another enquiry into what went wrong.
On the face of it the little lad appears to have been let down by the Local Authority social work department in a similar way as that which happened to the young girl Victoria Climbie who was murdered by her aunt and aunt’s boyfriend back in 2000.
I listened to various commentators talking about the case on the radio and there was a deal of consensus as to what might have been the failings.
There were complaints from social workers about having to spend 60- 70% of their working day inputting data on their office computer; time that it was suggested could be better spent out and about visiting families and protecting children. Not a good justification for the lack of action in the above case because the family apparently received something like 60 visits over a prolonged period of time.
I do, however, have some sympathy with this general view because I am aware that professionals in all walks of life are being saddled with increasing quantities of paperwork; quantities that might act as demotivators for the real job that is there to be done.
The Catch 22 situation for many of these professionals is that their effectiveness at their job may be judged largely on the quality of this paperwork.
One of the interviewers was a particularly shrewd and lucid individual who was able to simply put into words some of my own rather muddled thoughts on the subject. The gist of what she said was that managers can’t control what goes on inside a person’s head, they can only control what they see, i.e. the paperwork. And, she continued, it is in a professional’s head that the important work goes on.
To me, that simple concept is the crux of the matter and should be the gold standard by which any professional is judged, be they social worker, teacher, doctor or, indeed, veterinary surgeon. But who is to make that judgment?
Disagreement
I remember once asking a friend as to who he thought was the best person to judge the ability and competence of a vet. “The client” was his instant response. I could not have disagreed with him more.
From my perspective the client can certainly form an opinion as to how good or otherwise a vet might be. That opinion, though, is almost certain to be based on things that have little or nothing to do with the person’s veterinary expertise. Things like personality, physical attributes, communication skills, even dress code. I suspect clients are much more likely to consider a person a good vet if they like that person than if they don’t.
My suggestion to my friend was that the best person to judge the competence of a vet is one of his or her peers, i.e. another vet or vet nurse. The same I’m sure applies to the assessment of doctors, teachers and, of course, social workers.
The reason for this is that like the good lady above intimated, what makes a good professional is what goes on unseen in their head. And, of course, the actions they take as a result. Very different, for example, to what makes a good footballer or artist where everything they do and produce is clearly visible not just to their peers, but to all.
The great danger that comes from much of a professional’s expertise being hidden is the very real temptation to settle into a comfort zone whereby one’s own values and beliefs become a sort of Holy Grail.
Veterinary science as practised by an individual can all too easily be considered by that individual to be veterinary science at its best. The only way to counteract this somewhat unrealistic belief is for each and every one of us to have our professional knowledge, views, ideas and actions challenged constantly by our peers.
The concept of constant “challenge” should not be seen as threatening because it should be a two way process between equals, providing intellectual stimulation, food for thought and, indeed, empowerment.
It should be no more threatening than a self-critical analysis of our own abilities which in itself is frequently enlightening.
Understanding needed
The important thing is that any challenge should come from someone who fully understands the subject, condition, job in question. In that way they ask the right questions and also assess the thinking and judgment behind the answers given, and the justification for any action or lack of action that has been decided on.
The problem comes when managers do not understand the intricacies of the problem and the difficult decisions that might need to be taken by the person they are managing. It then comes down to the fall-back position of scrutinising the paperwork from which, in this binary world of computers in particular, it may be impossible to see the wood for the trees.
I don’t know all the facts of the very tragic case of Baby P but I suspect that if there had been more reliance on face-to-face discussion and peer review of the case, and rather less on procedural paperwork, then the outcome for the child in question might have been very different. We vets would do well to remember this principle when we are considering our own approach to what might be difficult and challenging clinical cases.
